Eiji Nishio

Asymptomatic synchronous quintuple primary cancers.

We encountered a 46-year-old woman with synchronous quintuple primary cancers. She did not present with any symptoms, and her tumors were discovered at a gynecological screening. She had clear cell adenocarcinoma of the right ovary, moderately differentiated endometrioid adenocarcinoma of the endometrium, moderately differentiated adenocarcinoma of the ascending colon, well-differentiated adenocarcinoma of the rectum, and poorly differentiated papillary adenocarcinoma of the left lung. A fluorodeoxyglucose-positron emission tomography and other imaging techniques were extremely useful for the diagnosis of multiple primary cancers. Moreover, MSH2 protein expression was absent in the tumors of the ovary, endometrium, ascending colon, and rectum, while the rectal cancer also lacked MLH1 protein. These findings suggested that an abnormality of DNA mismatch repair genes was responsible for carcinogenesis.

Two cases of ectopic ovary and one case of potential ectopic ovary

Ectopic ovary is a rare gynecologic entity. A variety of synonymous terms such as ectopic ovary, supernumerary ovary, accessory ovary, and autoamputation of the ovary have been used to describe this condition. The etiology for ectopic ovary has not been elucidated, but several mechanisms have been proposed. They are categorized as either congenital (embryologically derived) or acquired. This report presents two cases of ectopic ovary resulting from different causes and one case of potential ectopic ovary.

Preimplantation genetic diagnosis/screening by comprehensive molecular testing

Although embryo screening by preimplantation genetic diagnosis (PGD) has become the standard technique for the treatment of recurrent pregnancy loss in couples with a balanced gross chromosomal rearrangement, the implantation and pregnancy rates of PGD using conventional fluorescence in situ hybridization (FISH) remain suboptimal. Comprehensive molecular testing, such as array comparative genomic hybridization and next-generation sequencing, can improve these rates, but amplification bias in the whole genome amplification method remains an obstacle to accurate diagnosis. Recent advances in amplification procedures combined with improvements in the microarray platform and analytical method have overcome the amplification bias, and the data accuracy of the comprehensive PGD method has reached the level of clinical laboratory testing. Currently, comprehensive PGD is also applied to recurrent pregnancy loss due to recurrent fetal aneuploidy or infertility with recurrent implantation failure, known as preimplantation genetic screening. However, there are still numerous problems to be solved, including misdiagnosis due to somatic mosaicism, cell cycle-related background noise, and difficulty in diagnosis of polyploidy. The technology for comprehensive PGD also requires further improvement.

Identification of miRNAs in cervical mucus as a novel diagnostic marker for cervical neoplasia

AbstractmicroRNAs (miRNAs) play important roles in regulation of gene expression during cervical carcinogenesis. We investigated expression profiles of miRNAs in cervical cancer and its precursor lesions by utilizing cervical mucus. Cervical mucus was collected from 230 patients with a normal cervix, cervical intraepithelial neoplasia (CIN), squamous cell carcinoma (SCC), or adenocarcinoma (AD). The levels of miRNA in the mucus were quantified by miRNA array and real-time reverse-transcriptase polymerase chain reaction (RT-PCR). The performance for detecting diseases was statistically analysed. The expression of miRNAs was further validated in the surgical tissues of enrolled patients. Four miRNAs (miR-126-3p, -20b-5p, -451a, and -144-3p) were significantly up-regulated in SCC and AD compared with normal, and their expression levels correlated with disease severity and high-risk human papillomavirus infection. Receiver operating characteristic curve analyses revealed that the area under the curve values for miR-126-3p, -20b-5p, -451a, and -144-3p were 0.89, 0.90, 0.94, and 0.93, respectively, for SCC plus AD compared with normal, showing high accuracy of cancer detection. Real-time RT-PCR analyses confirmed the expression of these four miRNAs in frozen tissues from cervical cancer. miR-126-3p, -20b-5p, -451a, and -144-3p in cervical mucus are promising biomarkers for cervical cancer and high-grade CINs.

Successful fertility‐sparing surgery and chemotherapy for stage IC3 ovarian cancer with the postoperative use of the traditional Japanese herbal formulation Hachimijiogan: A case report

A 32‐year old, unmarried, nulligravida woman was diagnosed as having ovarian cancer stage IC3. The patient received six cycles of carboplatin and paclitaxel every 4 weeks after surgery. She was given a gonadotropin‐releasing hormone agonist as an ovarian safeguard while receiving treatment with anticancer agents.

Acknowledgment to the Reviewers

The editors greatly appreciate the support of all reviewers whose comments and scientific evaluation of submitted manuscripts are invaluable for ensuring the scientific quality of this journal. In addition to the listed permanent members of the Editorial Board, the following distinguished clinicians and scientists listed below acted as reviewers for Gynecologic and Obstetric Investigation from the beginning of November 2011 to the end of October 2012. The Editors hereby express their sincere gratitude for and their appreciation of the work done as well as the support given to this journal.

Chemical removal of zona pellucida versus laser assisted hatching after repeated failures of assisted reproductive technology

Background and AimsTo evaluate outcomes after zona pellucida removal by pronase or laser assisted hatching in women with repeated assisted reproduction failures.MethodsOf 389 procedures (January 2004 to November 2005), 203 control cycles had an intact zona, 116 cycles had chemical removal of the zona and 70 cycles had laser assisted hatching. Rates of pregnancy, implantation and abortion were compared, and pregnancy rate was secondarily evaluated for fresh or frozen-thawed blastocysts.ResultsPregnancy rates were 33.5% (68/203) for controls, 29.3% (34/116) for chemical removal and 30.0% (21/70) for laser. Implantation rates were 24.8% (68/274) for controls, 21.8% (34/156) for chemical removal and 30.0% (21/105) for laser. There were no significant differences among groups. Abortion rates were 15.6% (10/64) for controls, 13.9% (5/36) for chemical removal and 14.3% (3/21) for laser. No difference was observed by blastocyst type for control or laser assisted hatching cycles. In the chemical removal group, both pregnancy and implantation rates were higher for frozenthawed blastocysts than for fresh blastocysts. (41.5% vs 13.2% and 30.7% vs 11.1%, respectively).ConclusionsAssisted hatching did not show a significant benefit. Chemical zona pellucida removal might increase pregnancy rates for frozen-thawed blastocysts.